The background description includes information that may be useful in understanding the present invention. It is not an admission that any of the information provided herein is prior art or relevant to the presently claimed invention, or that any publication specifically or implicitly referenced is prior art.
The various phases of a patient's healthcare typically involves services provided by multiple providers which are often times separate from one another, with only the patient as the common link between all of them. Nevertheless, to properly provide the benefits and care that the patient needs typically requires that these separate provider entities communicate with one another. For example, a doctor communicates with a pharmacist via a prescription written by the doctor, which the pharmacist fills to dispense prescribed medication to the patient. However, these communications have traditionally been limited to relying on the patients themselves to carry a prescription, diagnosis, referral, or other type of treatment document from one provider to the next, only after which the providers may or may not communicate with one another to verify information. This reliance on patients to relay healthcare information creates a disconnect between the providers involved in the healthcare process of the patient, which creates an opportunity for mistakes or abuse. Inadvertent modification of prescription information by the patient, for example, can result in inadequate or dangerous medication dispensation by the pharmacist. A patient can also intentionally distort prescription information for the purposes of abuse. Additionally, patients deliberately seeking to abuse prescription medications have the ability to “doctor shop”, getting multiple prescriptions from multiple doctors, which are filled by multiple pharmacies that are all unaware of one another.
Despite the widespread availability of electronic data transfer and electronic communications, most Americans' medical information including treatment instructions and prescriptions is stored on paper—in filing cabinets at various medical offices, pharmacies, or in boxes and folders in patients' homes. Paper-based records require a significant amount of storage space compared to digital records. In the United States, most states require physical records be held for a minimum of seven years. The costs of storage media, such as paper and film, per unit of information differ dramatically from that of electronic storage media. When paper records are stored in different locations, collating them to a single location for review by a health care provider is time consuming and complicated, whereas the process can be simplified with electronic records. This is particularly true in the case of person-centered records, which are impractical to maintain if not electronic (thus difficult to centralize or federate). When paper-based records are required in multiple locations, copying, faxing, and transporting costs are significant compared to duplication and transfer of digital records. Because of these many “after-entry” benefits, federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic medical records. Further, this predominance of a paper based communication and archiving system helps to create the disconnect between providers, thereby exposing the stakeholders in healthcare to the potential for duplicate effort, prescription fraud, health claims fraud, and other similar and related costs to the healthcare system and society due to the absence of real time capture and exchange of patient specific health information.
The application and use of electronic health information exchange (HIE) allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient's vital medical information electronically—improving the speed, quality, safety and cost of patient care.
There are currently three key forms of health information exchange:                Directed Exchange—ability to send and receive secure information electronically between care providers to support coordinated care;        Query-based Exchange—ability for providers to find and/or request information on a patient from other providers, often used for unplanned care; and        Consumer Mediated Exchange—ability for patients to aggregate and control the use of their health information among providers        
The foundation of standards, policies and technology required to initiate all three forms of health information exchange are complete, tested, and available today.
Directed Exchange
Directed exchange is used by providers to easily and securely send patient information—such as laboratory orders and results, patient referrals, or discharge summaries—directly to another health care professional. This information is sent over the internet in an encrypted, secure, and reliable way amongst health care professionals who already know and trust each other, and is commonly compared to sending a secured email. This form of information exchange enables coordinated care, benefiting both providers and patients.
For example, a primary care provider can directly send electronic care summaries that include medications, problems, and lab results to a specialist when referring their patients. This information helps to inform the visit and prevents the duplication of tests, redundant collection of information from the patient, wasted visits, and medication errors.
Directed exchange is also being used for sending immunization data to public health organizations or to report quality measures to The Centers for Medicare & Medicaid Services (CMS).
Query-Based Exchange
Query-based exchange is used by providers to search and discover accessible clinical sources on a patient. This type of exchange is often used when delivering unplanned care.
For example, emergency room physicians who can utilize query-based exchange to access patient information—such as medications, recent radiology images, and problem lists might adjust treatment plans to avoid adverse medication reactions or duplicative testing.
In another example, if a pregnant patient goes to the hospital, query-based exchange can assist a provider in obtaining her pregnancy care record, allowing them to make safer decisions about the care of the patient and her unborn baby.
Consumer-Mediated Exchange
Consumer-mediated exchange provides patients with access to their health information, allowing them to manage their health care online in a similar fashion to how they might manage their finances through online banking. When in control of their own health information, patients can actively participate in their care coordination. For example, patients can participate by providing other providers with their health information, identifying and correcting wrong or missing health information, identifying and correcting incorrect billing information, and tracking and monitoring their own health.
Existing electronic healthcare communication systems attempt to remedy the dangers of cost, errors and abuse in healthcare processes by centralizing or otherwise synchronizing a patient's healthcare information among the providers associated with the patient. However, these systems typically require the installation of new infrastructure hardware and/or software components at each participating provider. The expenses and/or complexity of these systems limit the providers willing or able to participate in the system.
Others have made efforts towards developing systems and methods of secure healthcare information management. For example, U.S. Pat. No. 6,189,787 to Dorf titled “Multifunctional Card System”, issued Feb. 20, 2001, discusses the use of a multi-function card usable for various purposes. Dorf discusses that a type of transaction, transaction price, or selecting a function of the card can be entered via a PIN entry. However, Dorf's use of the PIN numbers for these purposes requires the entry of a purchase amount and the transferring of funds. Dorf does not discuss using a entering a payment amount for non-financial transactions. Additionally, any responses using the financial network itself are limited to purchase transactions. A response that provides information such as medical records requires the communication of the records outside of the financial transaction network.
U.S. Pat. No. 8,407,095 to Cunningham, et al titled “Method of Delivering a Pharmaceutical Product via a Medium”, issued Mar. 26, 2013, discusses using magnetic stripe cards for the management of prescriptions for medications. However, Cunningham requires modification of existing terminals by downloading of application programs. Further, Cunningham fails to discuss the function of these application programs, and does not discuss the nature of the data transmission.
US pre-grant application publication 2008/0126135 to Woo titled “Paperless Medication Prescription System”, published May 29, 2008, contemplates a paperless prescription management system using smart cards issued to patients. Woo does not discuss specifics of the nature of the data transferred, including the nature of the card readers, the data formats transferred or protocols used in data exchanges.
US pre-grant application publication 2010/0205005 to Pritchett, et al titled “Patient Oriented Electronic Medical Record System”, published Aug. 12, 2010, discusses an electronic medical records system accessible via smart cards. Pritchett does not discuss the specific communication protocols used, but the centralized system in Pritchett requires installing hardware, software and communication infrastructures at each participating provider capable of handling the data messages exchanged.
Applicants' prior work has been implemented in pilot programs, such as the Indianapolis DME pilot program and the TNRxSafety pilot program. However, the systems used in these pilot programs were not capable of conveying individual sets of information verifiable according to a sequential series of states for each set of information.
All publications herein are incorporated by reference to the same extent as if each individual publication or patent application were specifically and individually indicated to be incorporated by reference. Where a definition or use of a term in an incorporated reference is inconsistent or contrary to the definition of that term provided herein, the definition of that term provided herein applies and the definition of that term in the reference does not apply.
The following description includes information that may be useful in understanding the present invention. It is not an admission that any of the information provided herein is prior art or relevant to the presently claimed invention, or that any publication specifically or implicitly referenced is prior art.
In some embodiments, the numbers expressing quantities of ingredients, properties such as concentration, reaction conditions, and so forth, used to describe and claim certain embodiments of the invention are to be understood as being modified in some instances by the term “about.” Accordingly, in some embodiments, the numerical parameters set forth in the written description and attached claims are approximations that can vary depending upon the desired properties sought to be obtained by a particular embodiment. In some embodiments, the numerical parameters should be construed in light of the number of reported significant digits and by applying ordinary rounding techniques. Notwithstanding that the numerical ranges and parameters setting forth the broad scope of some embodiments of the invention are approximations, the numerical values set forth in the specific examples are reported as precisely as practicable. The numerical values presented in some embodiments of the invention may contain certain errors necessarily resulting from the standard deviation found in their respective testing measurements.
As used in the description herein and throughout the claims that follow, the meaning of “a,” “an,” and “the” includes plural reference unless the context clearly dictates otherwise. Also, as used in the description herein, the meaning of “in” includes “in” and “on” unless the context clearly dictates otherwise.
The recitation of ranges of values herein is merely intended to serve as a shorthand method of referring individually to each separate value falling within the range. Unless otherwise indicated herein, each individual value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g. “such as”) provided with respect to certain embodiments herein is intended merely to better illuminate the invention and does not pose a limitation on the scope of the invention otherwise claimed. No language in the specification should be construed as indicating any non-claimed element essential to the practice of the invention.
Groupings of alternative elements or embodiments of the invention disclosed herein are not to be construed as limitations. Each group member can be referred to and claimed individually or in any combination with other members of the group or other elements found herein. One or more members of a group can be included in, or deleted from, a group for reasons of convenience and/or patentability. When any such inclusion or deletion occurs, the specification is herein deemed to contain the group as modified thus fulfilling the written description of all Markush groups used in the appended claims.
Thus, there is still a need for a healthcare information exchange that allows for the secure exchange of a patient's healthcare information between providers in a secure manner that prevents mistakes or abuse, without requiring expensive, complicated infrastructure acquisitions and upgrades by participating providers.